| Objective The study is to explore the relationship between the polymorphism at site T2238 C of the atrial sodium urinary peptide precursor A(NPPA)gene and the clinical antihypertensive effect of amlodipine.Methods A total of 119 patients with mild and moderate EH(BP 140-179 mm Hg and/ or DBP 90-109 mm Hg who were treated or hospitalized in the Hypertension Clinic of the First Affiliated Hospital of Jiamusi University from October 2020 to October 2021 were randomly selected as the research object.All essential hypertension(EH)patients were diagnosed in accordance with "the 2018 Chinese Guidelines for Prevention and Treatment of Hypertension" and signed an informed consent.All EH patients who were included in the study did not take any antihypertensive medication or received any hypertension medication within two weeks.According to the instructions of "the 2018 Chinese Guidelines for Prevention and Treatment of Hypertension",the blood pressure measurements were carried out in a standard state,which was the same arm,by the same person,used the same sphygmomanometer to measure.General clinical data was collected including gender,age,height,weight,body mass index(BMI),heart rate(HR),smoking history,alcohol history,diabetes history,values of systolic blood pressure,diastolic blood pressure,and pulse pressure before and after medication.Blood samples were collected in this study,including fasting venous blood from patients before the treatment period to measure renin(Renin),angiotensin II(Ang II),aldosterone(ALD)and lipid-related indicators of triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C).Blood ions samples were collected,including cpotassium,calcium,fasting blood glucose,urinary sodium,etc.Another 2-3ml of venous whole blood without fasting was taken in EDTA anticoagulant tubes for genomic DNA extraction.Patients were instructed to take amlodipine tablets 5mg once a day,and to take orally at the same time point between7:00 and 9:00 am for 2 weeks.After 2 weeks of treatment,follow-up was conducted in the consulting room and the blood pressure of patients was measured.The groups based on the genetic test results was divided into wild-type TT type,heterozygous mutant TC type,and homozygous mutant CC type by the digital fluorescent molecular hybridization method.Due to the small amount of the CC type cases,the two groups were compared according to the TT type and TC / CC type groups to analyze the relationship between NPPA T2238 C gene polymorphisms and general clinical information of height,weight,age,sex,BMI,HR,abdominal circumference,smoking history,alcohol consumption history and diabetes history in EH patients.The relationship between NPPA T2238 C gene polymorphism and fasting plasma glucose,blood lipid,ions,urinary sodium,Renin,Ang Ⅱ and ALD in EH patients was analyzed.Meanwhile,the relationship between the polymorphism of NPPA T2238 C gene and SBP,diastolic BP,pulse pressure and antihypertensive amplitude before and after administration in EH patients were discussed.The antihypertensive efficacy was evaluated in accordance with the "Guidelines for Clinical Research of Drugs in the Cardiovascular System".This study discussed the antihypertensive efficacy,both markedly effective and effective in this article are judged to be effective,and the total effective rate is calculated.This study analyzed the T2238 C gene polymorphism was associated with the antihypertensive efficacy and total effective rate of amlodipine.Results 1.The NPPA T2238 C gene is consistent with Hardy-Weinberg equilibrium(P>0.05),so the gene is constant,which means the sample population is representative.The gene of TT type,TC type,and CC type are 68 cases(68%),25 cases(25%)and 7cases(7%)respectively,T allele frequency is 80.5% and C allele frequency is 19.5%.2.Compared with TT type patients,the gender,age,height,weight,BMI,HR,abdominal circumference,smoking history,drinking history,diabetes history and other general data of TC/CC type patients were not significantly different(P>0.05);3 Compared with TT type patients,the levels of fasting blood glucose,potassium,calcium,TG,TC,HDL-C,LDL-C,Renin,Ang Ⅱ,ALD,and urinary sodium of TC/CC type patients were not significantly different(P>0.05);4.Compared with TT type patients,TC/CC type patients were no significant difference in systolic blood pressure and diastolic blood pressure before medication(P>0.05),and there were no significant difference in pulse pressure before and after medication(P>0.05).The TC/CC type levels of systolic blood pressure and diastolic blood pressure after medication were significantly higher than those of TT type(P<0.01),and △SBP and △DBP were significantly lower than those of TT type(P<0.01).5.The total effective rates of TC/CC types and TT types were 75.00% and 91.18% respectively.Compared with TC/CC type and TT type patients,the antihypertensive effect of amlodipine was significantly lower than that of TT type(P<0.05).Conclusions 1.The NPPA T2238 C genetic polymorphism in EH patients has an influence on the antihypertensive effect of amlodipine.2.The NPPA T2238 C genetic polymorphism in EH patients has less effect on the levels of renin,angiotensin Ⅱ,aldosterone and urinary sodium;... |
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